A colonoscopy after bowel screening

If you get a 'not normal' BowelScreen home test result we will organise a free colonoscopy for you within 4 to 6 weeks.

A 'not normal' BowelScreen home test result means blood was found in your poo. A colonoscopy is a painless test to find out what is causing this.

What is a colonoscopy

A colonoscopy is a type of endoscopy test to look at your bowel using a small flexible camera. The camera is passed through your bottom (anus) and into your bowel.

A colonoscopy is not usually painful, but can cause mild discomfort or cramping for some people. But you can choose to have a medicine to make the test more comfortable (sedation). You will not feel pain.

A colonoscopy helps find:

• growths called bowel polyps that can turn into cancer
• the cause of blood in your poo
• what is causing bowel symptoms
• signs of bowel conditions

If your doctor finds any bowel polyps they usually remove them and send them to a lab for testing.

Preparing for your appointment

A BowelScreen nurse will phone you to:

• ask what medicines you take
• tell you how to prepare for a colonoscopy
• explain what happens during a colonoscopy

You will go to a BowelScreen endoscopy unit in a hospital for your colonoscopy. There are 17 around the country.

You do not need to stay overnight.

If you choose sedation you need to arrange for someone to bring you home after your appointment. This is because you cannot drive and cannot leave the unit alone after sedation .

The hospital will send laxatives for you to take before the colonoscopy and instructions on how to prepare for your colonoscopy. Make sure to read this 5 days before your appointment.

Your results

You get a letter or a phone call with your results 2 to 3 weeks after a colonoscopy. Your GP will get a copy of the report.

If the specialist who did your colonoscopy could not see all of your bowel we may contact you to have another colonoscopy or another test. This can happen if your bowel was not completely empty or the tube could not reach to the end of your bowel.

If you need a follow-up appointment, you will get a letter about this with the time and date.

Normal

A normal result means no growths (polyps) or cancer have been found in your bowel.

If you're at higher risk of bowel problems, you might be asked to have a colonoscopy every few years to check everything is still OK.

But a colonoscopy may not find all polyps - some may be hard to see. You may still be at risk of developing bowel cancer in the future.

You will still need to:

• do the BowelScreen home test every 2 years as long as you can
• check for signs and symptoms of bowel cancer

Growths (bowel polyps)

Your results may show that the specialist who did your colonoscopy found and removed bowel polyps.

They send a bowel polyp sample to be tested in the lab. Your results will include the next steps.

This could be either:

• more treatment
• a repeat colonoscopy in 3 years - this is called a surveillance colonoscopy

Bowel cancer

If your results say you have cancer, a team of specialists will work together to give you the best treatment and care.

The earlier anything is found, the easier and the quicker it can be treated.

What bowel cancer treatment involves

A bowel condition that's not cancer

A colonoscopy can help to confirm if you have a bowel condition that's not bowel cancer.

This could be:

• piles (haemorrhoids)
• Crohn's disease
• diverticular disease or diverticulitis
• ulcerative colitis

If you have one of these conditions, you may need more treatment.

Talk to your GP to find out the next steps.

What a BowelScreen colonoscopy can and cannot do

The main benefit of having a BowelScreen colonoscopy is it can find polyps in your bowel that could become cancer.

But having a BowelScreen colonoscopy does not always stop you from getting bowel cancer. Getting a normal result does not guarantee you are clear of bowel cancer.

This is because a colonoscopy may not find all polyps - some may be hard to see.

The main risks of having a colonoscopy are:

• bleeding
• tearing a hole in the wall of your bowel - known as perforation
• having a bad reaction to the anaesthetic or sedative used

Endoscopy risks

You can still develop cancer after your BowelScreen colonoscopy

You can still develop bowel cancer after either a colonoscopy with a normal result. This is called interval cancer. This is because it is found in the interval between your previous test and your next test.

Interval cancers are not common. But they happen in every screening programme.

For every 1,000 people in Ireland who have had a BowelScreen colonoscopy with a normal result:

• 996 will not get bowel cancer within 3 years of their BowelScreen colonoscopy
• 4 will get bowel cancer within 3 years of their BowelScreen colonoscopy

If you get bowel cancer after a BowelScreen colonoscopy with a normal result you can ask for a review.